Prognostic significance of histologic findings in resected small hepatocellular carcinoma.

Fifty-one patients with histologically proven small (less than 5 cm) hepatocellular carcinoma underwent hepatic resection. In ten cases (group A) the cancer cells were confined within the tumor capsule, in ten (group B) there was extracapsular extension of growth, in 23 (group C) there was also invasion of the portal vein from the main tumor or from satellite nodules, or both, and in eight cases (group D) the findings were the same as in group C but there was no tumor capsule. The mean follow-up period was 54 +/- 12 months, minimum 37 months. The estimated 7-year survival rates in groups A-D were, respectively 100, 47.5, 47.5 and 37.5%. The classification of gross tumor appearance as typical or atypical was fairly well correlated to the histologic pattern in groups A, C and D, but not in group B. Although safety margin at resection did not emerge as a prognostic factor, the group A patients with a good margin were free from tumour recurrence.